The Therapeutic Potential of Cefiderocol in the Treatment of Multidrug-Resistant Gram-Negative Bacteria: A Narrative Review.

Background: Increasing antimicrobial resistance (AMR) is one of the leading causes of death worldwide. The predominant pathogens that exacerbate the AMR problem are multidrug-resistant (MDR) Gram-negative bacteria (GNB). Due to the increasing adaptation of MDR GNB to commercially available antimicrobial drugs, such as carbapenems as well as third- and fourth-generation cephalosporins, pharmaceutical companies around the world have been forced to produce increasingly innovative chemotherapeutics. Cefiderocol (CFDC) is a novel injectable cephalosporin 5 generation developed by Shionogi, directed against MDR GNB, including strains resistant to carbapenems. Results: Analysis demonstrated its significant efficacy across a wide range of in vitro and in vivo studies against MDR GNB, including Carbapenem-resistant Pseudomonas aeruginosa (CRPA), Carbapenem-resistant Acinetobacter baumannii (CRAB), and carbapenem-resistant Enterobacterales (CRE) (WHO Critical Priority Pathogens). Clinical studies have shown CFDC to be an effective drug with few adverse effects. Conclusions: When used CFDC appropriately within antibiotic stewardship guidelines, this drug is an effective, well-tolerated targeted treatment option for patients with severe clinical conditions.